Hundreds of colleges and universities across the nation are requiring students to be fully vaccinated against Covid-19 before returning to campuses in the fall, but the mandates may be difficult to enforce fully.
Some schools such as Princeton University are requiring students to be fully vaccinated by Aug. 1, but it's still unclear how others will manage vaccination and mask mandates — or what alternatives to on-campus learning may be offered to students who aren't inoculated against Covid-19.
A number of colleges contacted by NBC News declined to comment, pointing to their websites for requirements.
“There is a lot of vaccine hesitancy, and colleges are places that have a high risk for transmission since people congregate in classrooms and school buildings such as dorms,” said Kristin Bratton Nelson, assistant professor of epidemiology at the Emory University Rollins School of Public Health.
Most universities won’t require students to submit a copy of an official vaccination card as proof, which could make the policies difficult to enforce, said public health expert Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington.
According to the Chronicle of Higher Education, which is tracking the issue, 578 college campuses currently require students to be fully vaccinated against Covid-19 before returning for the fall semester. The American College Health Association advises all colleges and universities to implement vaccination mandates for students and staff, but the logistics are proving to be complicated.
For example, a lawsuit brought by eight Indiana University students is awaiting a ruling on whether the school's vaccination mandate is legal under state laws that prohibit vaccine passports. In response to an opinion published by Indiana Attorney General Todd Rokita in May, the university dropped its proof of vaccination requirement and only requires nonexempt students to indicate whether or not they have been vaccinated. And Boston College’s refusal to grant a religious exemption for students at the Catholic school has angered some students and parents who are requesting a change in policy.
'Quite a few' exemption requests
Some students opposed to mandates see vaccination as a personal choice — and exemptions as a way to bypass mandates.
“I feel that I shouldn't be forced to get the shot by a school that I’m paying to go to,” said a 19-year-old rising sophomore at Hofstra University on Long Island, who requested that she not be identified.
She told NBC News that she does not agree with the university requiring students to get the Covid-19 vaccination before returning to campus, and even considered transferring to a school that does not require the vaccination.
Although she does not have a medical condition that would make it dangerous for her to get vaccinated, she found a doctor who would sponsor a medical exemption and plans to submit a request before returning to campus in August.
“I’m not at all against getting vaccinated, but I feel like the vaccine is kind of new and I would rather wait to get it until it’s approved by the FDA, just to have peace of mind,” she said.
This is a challenge all schools with mandates will face: How will exemption requests be vetted, and what will the penalties be for falsifying information? The differences between just a handful of schools illustrate how the mandates vary.
Some schools, including Hofstra, have outlined specific health conditions to be medically exempt from the vaccination. Others are vague. University of Connecticut students don’t need to have a specific condition to apply for a medical exemption, but must have a health care professional attest that the Covid-19 vaccines would endanger their life or health.
Students at Indiana University are required to be vaccinated by Aug. 1, but can apply for exemptions if they are allergic to any component of the Covid-19 vaccines. They can apply for vaccination deferral if they are pregnant, breastfeeding, immunocompromised or have received monoclonal antibodies specific to Covid-19 in the past 90 days.
Already, Indiana University has received “quite a few” exemption requests, Chuck Carney, a spokesperson for the school, said in an email.
Medical exemptions and deferrals require a health provider’s signature. Religious exemptions, which most schools have voluntarily included, are almost always based on the honor system.
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“The religious exemption requires an online attestation that they request an exemption based on religious reasons, with the potential of disciplinary action for falsely making that claim,” Carney said.
In-person students at Indiana University who do not get the vaccination and who are not exempt will be unregistered from classes, have their access to university systems such as email terminated, and will not be allowed to participate in any on-campus activity, the school’s website states. But the penalties for fabricating a request are vague.
Hofstra will offer online classes to students who are unvaccinated without an exemption, and students who falsify records are “subject to the policies in the University’s Code of Community Standards,” Jean C. Peden-Christodoulou, associate vice president of Hofstra, said in an email. However, specific repercussions are unclear.
University of Connecticut campuses require in-person students to be fully vaccinated, but it’s unclear whether or not remote learning will be an option, only that students will face “loss of privileges and/or sanctions.”
Several states, including Florida, Indiana and Texas, have legislation prohibiting governments from passing laws that require "vaccine passports." Some have interpreted this as applying to public universities as well, but many legal questions remain regarding the difference between private and public colleges.
Additional legal uncertainty lies in the fact that all Covid-19 vaccines currently hold emergency use authorization status, and it’s unclear when the shots will be fully approved by the Food and Drug Administration.
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“Universities have a duty to provide a safe campus and vaccination might be a part of that,” said Dorit Reiss, a professor of law at the University of California in San Francisco, who specializes in legal issues related to vaccines. “We need some guidance on this at the federal level.”
Despite the pushback, some experts say, mandates for college students will drive a much needed uptick in vaccination rates among younger adults.
“Mandates will help in younger age groups, where the perception is often that they don’t have to worry about getting very sick from Covid-19,” said Murray of the University of Washington, who expects vaccination rates among young adults to climb in the next month as a result of the mandates.
Majority in favor of mandates
In May, a Gallup Poll of 3,500 Americans found that roughly 60 percent were in favor of colleges requiring students to be vaccinated against Covid-19.
Evan Levine of Camden County, New Jersey, whose son is a rising junior at Princeton, said he’s grateful for the school’s vaccination mandate and hopes the requirements will become the status quo as more schools implement the policy.
“Especially with the variants and rising infection rates in unvaccinated people, if the mandate to be vaccinated to be on campus was not there, I feel there would absolutely be more lost time,” he said, referring to remote learning over the past year.
Both Levine and his son, who is fully vaccinated, were notified of Princeton’s mandate via email in May.
“I feel like Princeton is throwing these kids a life raft with these mandates. If you want to experience college the way it’s intended to be, getting a shot should be a no-brainer,” Levine said.